ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019
MRI for high ankle sprains with an unstable syndesmosis: posterior malleolus bone oedema is common and time to scan matters.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 30 citations in OpenAlex.
- [Arthroscopy in the treatment of acute and chronic syndesmotic injuries of the ankle joint].Operative Orthopadie und Traumatologie · 2025Trial
- [Injuries of the tibiofibular syndesmosis].Unfallchirurgie (Heidelberg, Germany) · 2026Article
- High ankle sprains in athletes: A comprehensive imaging focused review.Skeletal radiology · 2026Review
- Clinical and CT-Based Outcomes of Anterior and Posterior Syndesmotic Augmentation Using Nonabsorbable Suture Tape for Acute Syndesmotic Instability: A Preliminary Case Series of Seven Patients.Journal of clinical medicine · 2026Article
- Bilateral External Rotation Torque CT Remains Reliable in Syndesmotic Assessment Despite Lateral Ligament Injury, but Reveals Increased Tibiotalar Rotational Instability.Foot & ankle orthopaedics · 2026Article
- Syndesmotic and Deltoid Injuries: Companions or Coincidences.Foot & ankle international · 2024Article
- The distal tibiofibular joint effusion may be a reliable index for diagnosing the distal tibiofibular syndesmosis instability in ankle.Skeletal radiology · 2024Article
- In Different Gender Groups, What Is the Impact of the Fibular Notch on the Severity of High Ankle Sprain: A Retrospective Study of 360 Cases.Orthopaedic surgery · 2023Article
- Preoperative CT parameters to predict tibiofibular syndesmosis injury associated with ankle fracture: a propensity score-matched analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Ankle Sprains in Athletes: Current Epidemiological, Clinical and Imaging Trends.Open access journal of sports medicine · 2023Review
- Letter to the Editor: Can Weightbearing Cone-beam CT Reliably Differentiate Between Stable and Unstable Syndesmotic Ankle Injuries? A Systematic Review and Meta-analysis.Clinical orthopaedics and related research · 2022Article
- Acute clinical evaluation for syndesmosis injury has high diagnostic value.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- A systematic review and meta-analysis on the value of the external rotation stress test under fluoroscopy to detect syndesmotic injuries.EFORT open reviews · 2022Review
- Comparison of Treatment Methods for Syndesmotic Injuries With Posterior Tibiofibular Ligament Ruptures: A Cadaveric Biomechanical Study.Orthopaedic journal of sports medicine · 2022Article
- The prevalence of posterior inferior tibiofibular ligament and inferior tibiofibular transverse ligament injuries in syndesmosis-injured ankles evaluated by oblique axial magnetic resonance imaging: a retrospective study.BMC musculoskeletal disorders · 2022Article
- Bilateral ankle syndesmosis injury: a rare case report.Orthopedic reviews · 2022Article
- The ankle syndesmosis pivot shift "Are we reviving the ACL story?"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021Article
- APKASS Consensus Statement on Chronic Syndesmosis Injury, Part 1: Clinical Manifestation, Radiologic Examination, Diagnosis Criteria, Classification, and Nonoperative Treatment.Orthopaedic journal of sports medicine · 2021Article
- APKASS Consensus Statement on Chronic Syndesmosis Injury, Part 2: Indications for Surgical Treatment, Arthroscopic or Open Debridement, and Reconstruction Techniques of Suture Button and Screw Fixation.Orthopaedic journal of sports medicine · 2021Article
- Delayed stabilisation of dynamically unstable syndesmotic injuries results in worse functional outcomes.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
purposeEarly clinical examination combined with MRI allows accurate diagnosis of syndesmosis instability after a high ankle sprain. However, patients often present late. The aims of the current study were to describe MRI characteristics associated with syndesmosis instability and to test the hypothesis that MRI patterns would differ according to time from injury.
methodsOver a 5-year period, 164 consecutive patients who had arthroscopically proven syndesmosis instability requiring fixation were retrospectively studied. Patients with distal fibula fractures were not included. Injuries were classified as acute in 108 patients (< 6 weeks), intermediate in 32 (6-12 weeks) and chronic in 24 patients (> 12 weeks).
resultsPosterior malleolus bone oedema was noted in 65 (60.2%), and posterior malleolus fracture in 17 (15.7%) of acute patients, respectively, which did not significantly differ over time. According to MRI, reported rates of posterior syndesmosis disruption significantly differed over time, observed in 101 (93.5%), 28 (87.5%) and 13 (54.2%) of acute, intermediate and chronic patients, respectively (p < 0.001). Apparent rates of PITFL injury significantly reduced with time (p < 0.001).
conclusionsMRI detected a posterior syndesmosis injury in 93.5% of patients acutely but became less reliable with time. The clinical relevance of this study is that posterior malleolus bone oedema may be the only marker of a complete syndesmosis injury and can help clinically identify those injuries which require arthroscopic assessment for instability. If suspicious of a high ankle sprain, we advocate early MRI assessment to help determine stable versus unstable injuries as MRI becomes less reliable after 12 weeks. LEVEL OF EVIDENCE: III.
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